Camp Mo 2024 & Minor Medical Consent

Authorized Guardian Info

You are responsible to keep Contact updated with any changes to the following information (especially phone number!)

Name

This address will receive a confirmation email

Phone

Address

Birthdate

Gender Male Female

If you have medical insurance, who is your provider?

Emergency Contact Information

Emergency Contact's Name

Emergency Contact's Phone Number

EC's Relationship to Children

Camper Information

Please write out names, birthdays, and any allergy or medical information here for all people who plan to attend Camp Mo.

Children's Medical Consent

If any minors in your family plan to attend, please fill out separate info for each child.

Child 1 Name

Child 1 Birthdate

Child 1 Gender Male Female

Allergies

Medications and Instructions for Medications

Blood Type (If Known)

Date of Last Tetanus Shot

Other Important Information

Child 2

Scroll to bottom if no more children to register

Child 2 Name

Child 2 Birthdate

Child 2 Gender Male Female

Allergies

Medications and Instructions for Medications

Blood Type (If Known)

Date of Last Tetanus Shot

Other Important Information

Child 3

Scroll to bottom if no more children to register

Child 3 Name

Child 3 Birthdate

Child 3 Gender Male Female

Allergies

Medications and Instructions for Medications

Blood Type (If Known)

Date of Last Tetanus Shot

Other Important Information

Child 4

Scroll to bottom if no more children to register

Child 4 Name

Child 4 Birthdate

Child 4 Gender Male Female

Allergies

Medications and Instructions for Medications

Blood Type (If Known)

Date of Last Tetanus Shot

Other Important Information

Child 5

Scroll to bottom if no more children to register

Child 5 Name

Child 5 Birthdate

Child 5 Gender Male Female

Allergies

Medications and Instructions for Medications

Blood Type (If Known)

Date of Last Tetanus Shot

Other Important Information

Child 6+

If you have more children to register, please include their names, birthdays, gender, allergies, medications and instructions, blood type, date of last tetanus shot, and any other important information.

Additional Children

Camp Mo 2024 & Minor Medical Consent

Description

Please Fix the Following